Functional electrical stimulation (FES), in which stimulation of nerves is conducted, is a method known for several decades and has been used for activating paralyzed muscles. The conventional treatment methods of rehabilitation movement functions of post CVA patients are based on electrostimulation, while the patient plays a passive role in the process of therapy.
Electrical massage is known by the term TENS (transcutaneous electrical nerve stimulation). TENS acts as a pain reducer. The stimulation of the muscles causes a higher blood flow to the area, hence a massage effect. TENS causes also the release of endorphins for further ease of the pain.
Assisting the muscular contraction by affecting a muscle with a stimulating impulse is known and used. For example, an assisting apparatus is disclosed in U.S. Pat. No. 4,785,813 “Apparatus for Assisting Muscular Contraction” filed in 1986 by Petrofsky. This system is for assisting contraction of a partially paralyzed muscle. The system uses a pair of electrode terminals, which sense voluntary electromyogram (EMG) impulses at the site of the muscle and periodically transmit appropriately corresponding higher-level stimulation impulses.
One of the rehabilitation processes used for patients suffering from partial muscle paralysis such as CVA patients is the reeducation of the muscle to conduct voluntary actions. Another example that takes the above considerations into account is U.S. Pat. No. 4,811,742 “Proportional Response Electrical Muscle Stimulation” filed in 1985 by Hassel et al. This patent discloses measuring the excitation of the skeletal musculature of a subject by an EMG, processing it and controllably applying to the musculature EMG impulses that are proportional to the electrical nerve impulses. This invention is useful for reeducation and/or amplification of muscular control.
The display of the EMG impulses for the selection of transmitted impulses is also a known prior art. Such a device was filed in 1992 and is disclosed in U.S. Pat. No. 5,300,096 “Electromyographic Treatment Device” by Hall et al. This invention discloses an electrical muscle stimulator that converts EMG impulses to digital words for the analysis and display by a computer program. The therapists selects a variety of different parameters appropriate for the individual patient, and instruct the device to initiate stimulating impulses on command, or upon detection of a suitable EMG impulse from the patient. The device can digitally model a wide variety of waveforms and graphically assist the therapist in developing and shaping various wave pulse trains.
Control over the process of muscles rehabilitation may be achieved upon the combination of transmitting impulses to the muscle similarly to the methods indicated herein above with receiving some indication from the muscle on its function or response. Such combination is disclosed in U.S. Pat. No. 5,549,656 “Combination Neuromuscular Stimulator and Electromyograph System” filed in 1995 by Reiss. This patent discloses a combined dual channel electromuscular stimulator for directing electrical pulses into the skin and a dual electromyography for detecting electrical impulses generated in muscles. Another example for a controlled system was filed in 1987 and is disclosed by Barry et al. in U.S. Pat. No. 4,805,636 “System for Controlling Muscle Response”. This system for controlling muscular responses in living beings utilizes electrical stimulation of the muscle and acoustic monitoring of muscle performance. In one aspect, muscle functioning during a physical activity can be monitored acoustically, and the resulting impulse compared against predetermined impulse characteristics. Deviation of the muscle function from the desired characteristic can be corrected by applying a responsive electrical impulse.
In all former disclosed devices and methods, including the controlled devices, the methods focus on the therapist abilities to transmit impulses to the patient or to receive information. The patient in all the previous methods is a passive being that is activated by transmission of electrical stimulation. The patient is not contributing to his rehabilitation and has no control over his treatment. In rehabilitation processes in general, and also in many other therapeutic treatments, the collaboration and motivation of the patient in the process is very important to its success. The activation of muscles is a voluntary action in which the contribution of activating and participating the patient to the success of the process is evident.